Related Activities
• With Duke and CDC, fostering public health / primary
care integration though “Practical Playbook” project
(practicalplaybook.org)
• Focused on public health workforce including work with
the Public Health Informatics Institute (PHII) to help form
Public Health Informatics Academy and the PHII
Requirements Lab (www.phii.org/what-we-do)
• Committed to advancing informatics for a strong public
health system
4
Context
•
Public health informatics at critical juncture
•
Over 70% of hospitals and 45% of community providers
now have Electronic Health Records (EHRs) subsequent
to over 30 billion in public incentive dollars
•
Health departments not commensurately supported to
participate in electronic interaction with clinical care
•
Electronic Health Records (EHRs) do not address many
population health functional needs
Context
•
New clinical payment methodologies and the
Affordable Care Act (ACA) are pushing clinical care
organizations to address more population health
functions
•
Health is rapidly entering an era of “big data” and
clinical care is the largest health data producer
•
Jurisdictional, infrastructural, privacy, data and
workforce challenges continue to face public health
informatics
Relevant Terms
• Population
Population
Health
health
• Public
health
• Population
health
management
Clinical
Care
Population
Health
Management
Health
Department
Public
Health
Question
How should public health informatics
proceed in this age of Electronic Health
Records and the Affordable Care Act?
8
Methods
• Initiated interviews with senior thought leaders
• Convened 32 public health, clinical care, and
health informatics leaders including senior
representation from the CDC, ONC, ASTHO,
NACCHO, CSTE and others
• Discussed industry trends, challenges and
strategies for moving forward
• Complete findings and plans will be forthcoming
9
Findings
• EHRs are only one of many important health IT
applications
• Population health management and public health
share a number of common functions
• Clinical care population health will principally focus
on the 5% of patients who use 50 to 80% of health
resources
• Health Information Exchange organizations are either
"the answer“ for public health or are "dead"
10
Findings – “Information”
• Public health access to EHRs, multi-payer claims
databases, and reported data is frequently nonexistent or problematic
• Factors involved in connecting to clinical care
and low public health "Meaningful Use"
reporting numbers are complex
• Basic case reporting still eludes automated
clinical care – public health exchange
11
Findings – “Public Health”
• Data sciences for big data clinical care analytics
are not yet reconciled with epidemiology
• Needs for a "value exchange" / partnership
between Accountable Care Organizations and
public health
• Public health funding silos impede progress
• Health departments will continue to offer the
“jurisdictional denominator” and complete
population perspective
12
Initial Conclusions
• Needs for action
• Government HITECH and ACA efforts do not
significantly advance informatics solutions
for a strong, population-inclusive public
health system
• Clinical care organizations and EHR vendors
are early in consideration of population
health functions
13
Strategies
• Establish public health /
clinical care value
equation
•
e.g. a public health – ACO
business contract
• Advance second
generation approaches to
accessing information
•
e.g. role-based access
"accounts" in EHRs for
public health workers
Population
Health
Clinical
Care
Population
Health
Management
Health
Department
Public
Health
Data,
Value,
and
Synergies
Strategies
• Help rationalize health
department and population
health IT
•
e.g. sharing population
health and public health
reporting infrastructure
• Align population health
incentives, funding and
workforce
•
e.g. help reduce barriers
from silo'ed program funding
Population
Health
Clinical
Care
Population
Health
Management
Health
Department
Public
Health
Data,
Value,
and
Synergies